crossing96/oncoscreening huggingface dataset:
Evaluation of the diagnostic performance of YiDiXie™ tests in urothelial carcinoma.	BACKGROUND: Computed tomography (CT) is widely used to the diagnosis of upper urinary tract epithelial tumors, but the relatively inaccurate results may affect subsequent treatment. Cystoscopy is widely used for preoperative diagnosis of bladder tumors and postoperative review of urothelial carcinoma, but its invasiveness and corresponding complications are feared by patients. There is an urgent need to find a convenient, cost-effective and non-invasive diagnostic method to reduce the false-positive and false-negative rates of urinary tract CT, and to replace cystoscopy in the preoperative diagnosis of bladder tumors or postoperative monitoring the bladder for recurrent of urothelial carcinoma. The study aimed to evaluate the diagnostic value of YiDiXie™-30, YiDiXie™-32, and YiDiXie™-48 in urothelial cancer. MATERIALS AND METHODS: 439 study subjects were finally included in this study (malignant group, n = 292, benign group, n = 90; relapse group, n = 22, relapse-free group, n = 35). The remaining serum samples from the subjects were collected and tested by applying the YiDiXie™ all-cancer detection kit to evaluate the sensitivity and specificity, positive likelihood ratio, and negative likelihood ratio of YiDiXie™-30, YiDiXie™-32, and YiDiXie™-48. Receiver-operating characteristic curves' analyses were included in this study. RESULTS: The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of YiDiXie™-30 were 74.7%, 92.2%, 9.6, and 0.27, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of YiDiXie™-32 were 86.6%, 84.4%, 5.6, and 0.16, respectively. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 96.2%, 65.6%, 2.8, and 0.06, respectively. Further studies revealed that YiDiXie™-30, YiDiXie™-32, and YiDiXie™-48 had similar results in patients with positive or negative urothelial CT. The negative likelihood ratios of YiDiXie™-30, YiDiXie™-32, and YiDiXie™-48 with ultrasound concurrently in the relapse and relapse-free groups were 0.05, 0.05, and 0. In the malignant and benign groups with diameters < 2.0 cm negative likelihood ratios of YiDiXie™-30. CONCLUSION: YiDiXie™ tests showed considerable validity in the diagnosis of urothelial carcinoma with significantly different levels of sensitivity and specificity. They have significant diagnostic value in urothelial carcinoma, improving the diagnosis of upper urinary tract epithelial tumors and potentially providing an alternative to cystoscopy in combination with CT or ultrasound. Clinical study registration number ChiCTR2200066840.	bladder
Plasma lipidomics for biomarker identification in non-muscle invasive bladder cancer.	BACKGROUND: Bladder cancer is a high-incidence malignant tumor in the world. Currently available potential biomarkers lack sufficient diagnostic accuracy, underscoring the need for novel biomarkers. Lipid metabolites have emerged as promising candidates for diagnosing malignant tumors in recent years. Few studies explored the potential value of lipids in bladder cancer. Our study investigated plasma lipid metabolism markers in non-muscle invasive bladder cancer (NMIBC) using liquid chromatography-high resolution mass spectrometry (LC-HRMS). METHODS: Overall, 214 cases were included, with 106 NMIBC patients as NMIBC group and 108 healthy adults as control group. Plasma lipids were profiled using LC-HRMS to distinguish NMIBC group from control group, low-grade NMIBC group from control group and low-grade NMIBC group from high-grade NMIBC group. RESULTS: Apparent separation was observed between NMIBC group and control group. Hydroxy fatty acids, O-TAG, O-LPG and hydrocarbons metabolites were significantly enriched in NMIBC group. A Lipids panel of PE(14:1/20:0), PE(18:2/16:0) and 19-methyl-heneicosanoic acid was used to conduct a predictive model of NMIBC group and control group. The model showed acceptable accuracy for NMIBC diagnosis with the area under the curve (AUC) of 0.88 and 0,82 for training and validation cohorts, respectively, especially for the low-grade NMIBC diagnosis with the AUC of 0.81. For low- and high-grade NMIBC distinction, a panel of four lipids achieved good performance with the AUC value of 0.815 (10-fold cross validation: 0.77; leave-one-out validation (LOOCV):0.77). CONCLUSION: Lipid profiles differed significantly between patients with non-muscle invasive bladder cancer (NMIBC) and healthy adults. The identified lipid biomarkers demonstrated high discriminatory accuracy in diagnosing and grading NMIBC, indicating their promising clinical potential for both detection and monitoring of bladder cancer.	bladder
Outcomes of sequential therapy for advanced upper tract urothelial cancer and bladder cancer.	This multicenter retrospective study compared clinical outcomes and sequential therapy patterns between upper urinary tract urothelial carcinoma (UTUC) and bladder cancer (BC). Data from 517 patients with locally advanced/metastatic urothelial carcinoma diagnosed between January 2020 and December 2021 at 54 Japanese institutions were analysed (232 UTUC, 285 BC). UTUC patients were more likely to have poor renal function and metastases to the lung, liver. Multivariate analysis identified UTUC as an independent risk factor for overall survival (OS). UTUC showed significantly shorter progression-free survival (PFS) and lower response rates to first-line chemotherapy than BC (28.9% vs. 38.2%). These findings persisted after propensity score matching. OS following second-line therapy was also inferior in UTUC, although the rate of transition to second-line therapy was similar between groups. However, a higher proportion of UTUC patients (47.9%) could not proceed to third-line therapy, mainly due to disease progression or adverse events. Overall, UTUC was associated with a worse prognosis than BC. These results highlight the urgent need for more effective first-line treatments, such as immune-combination therapies, particularly in synchronous UTUC cases. ・Keywords: bladder cancer, chemotherapy, prognosis, sequential therapy, upper urinary tract urothelial cancer.	bladder
Blood urea nitrogen and bladder cancer: A Mendelian randomization study.	"The causal relationship between blood urea nitrogen (BUN) level and bladder cancer (BC) was analyzed by 2-sample Mendel randomization method, in order to provide help for the screening of high-risk groups of BC. Based on the summary data of whole genome association analysis, and Mendelian randomization (MR) is performed using inverse variance weighted (IVW), weighted median (WME), and MR Egger regression methods. IVW analysis is the main result, supplemented by WME and MR Egger regression results. Cochran Q statistics, MR Egger intercept term, MR-PRESSO test, leave 1 out method, and funnel plot are used for sensitivity analysis to ensure the robustness of the analysis results. A total of 178 single nucleotide polymorphisms strongly associated with BUN level were included. IVW analysis showed that there was a causal relationship between blood ureanitrogen and BC (OR = 1.0016, 95% CI: 1.0004-1.0027, P <.05). WME analysis results supported the above conclusions, but MR Egger regression analysis did not show a causal relationship between the 2. Cochran Q statistic P >.05, MR Egger intercept method (P = .63), MR-PRESSO test (P = .36), ""leave one out"" method, and funnel plot analysis all indicate that there is no heterogeneity or horizontal pleiotropy in the MR analysis of the 2 samples, and the analysis results are stable and reliable. There is a causal relationship between high BUN levels and BC, which provides reference for prevention and treatment of BC."	bladder
The utility of radiopharmaceutical uptake in the bladder neck and prostate on preoperative FDG PET/CT in determining urethral surgical margin positivity in patients undergoing radical cystoprostatectomy for bladder cancer.	BACKGROUND: Bladder cancer is the most common malignancy of the urinary system. It is a heterogeneous type of cancer with a high potential for metastasis, approximately 25% of which occurs as muscle invasive. As with other malignancies, accurate and precise staging of bladder cancer is one of the mainstays for choosing the most appropriate treatment for the patient. Detection of metastasis is extremely important in choosing the treatment strategy. FDG PET/CT is widely used in the clinical management of various malignancies and is increasingly used in the primary staging of muscle-invasive bladder cancer and detection of recurrence after radical cystectomy. We aimed to determine the role of radiopharmaceutical uptake in the bladder neck and prostate region in preoperative FDG PET/CT in patients with muscle-invasive bladder tumors in determining the positivity of prostatic urethra surgical margins in the final pathology after cystectomy and its effect in determining the type of diversion to be chosen. METHODS: The data of male patients who underwent FDG PET/CT before radical cystectomy due to MIBC between January 2009 and January 2023 in the Department of Urology at Istanbul Faculty of Medicine were retrospectively analyzed. The correlations between the presence of radiopharmaceutical uptake in the bladder neck or prostate in FDG PET CT and the positivity of the prostatic urethra surgical margin in the postoperative final pathology of these patients and the invasion of urothelial carcinoma in the prostate were analyzed. RESULTS: Prostatic urethra surgical margin positivity was detected in 8 of 50 male patients who had FDG PET CT in the preoperative period. Prostatic urethra surgical margin positivity was detected in 5 of 19 patients with bladder neck and prostate region involvement on FDG (p = 0.2554). Prostate involvement was seen on FDG in 6 of 9 patients with urothelial carcinoma invasion into the prostate (p = 0.1492). Prostate adenocarcinoma was observed in the final pathology of 12 patients, and 8 of these patients had FDG uptake (p = 0.106). While no statistically significant relationship was found between the presence of bladder neck and prostate region involvement on FDG and prostatic urethra surgical margin, urothelial carcinoma invasion into the prostate and prostate adenocarcinoma, a statistically significant relationship was observed between the presence of malignancy in the prostate (urothelial carcinoma and/or adenocarcinoma) (p = 0.0189). CONCLUSIONS: While no statistically significant relationship was found between radiopharmaceutical uptake in the bladder neck and prostate region on preoperative FDG PET CT in CIBC and prostatic urethra surgical margin positivity, urothelial carcinoma invasion into the prostate and the presence of prostate adenocarcinoma; It was found valuable in detecting the presence of malignancy in the prostate (adenocarcinoma/urothelial carcinoma).	bladder
Detection of spontaneous anti-neoepitope T-cell responses in non-metastatic bladder cancer patients.	BACKGROUND: Bladder carcinomas are immunogenic, and patients with bladder cancer benefit from immune checkpoint therapy. This is correlated to a high tumor mutation burden, which provides a higher number of neoepitopes that can be recognized by tumor-specific CD8(+) T cells. Intravesical Bacillus Calmette-Guérin (BCG) is used to treat non-muscle invasive bladder cancer (NMIBC), but its mechanism of action remains elusive. Most lymphocytes appearing in the urine of BCG-treated patients are CD4(+) T cells though preclinical studies showed that CD8(+) T cells are also necessary for BCG treatment efficacy. It is currently unknown which proportion of patients with non-metastatic bladder cancer develop a spontaneous antitumor CD8(+) response, and if BCG treatment influences this response. METHODS: In a first cohort of 15 NMIBC and 9 muscle invasive bladder cancer patients, we used IFN-y ELISPOT assays to screen for the presence of anti-neoepitope CD8(+) T cells in the blood, tumor and urine. In a second cohort of 4 NMIBC patients, we analyzed the features and specificity of CD8(+) T cells infiltrating the tumoral or bladder tissues before and after BCG using single cell transcriptomic analyses. A total of 31 tumor-infiltrating CD8(+) clonotypes were screened against neoepitopes and tumor cDNA libraries. RESULTS: 9 out of 24 patients from the first cohort mounted a spontaneous and functional anti-neoepitope T-cell response in blood and/or tumor. In 5 patients from this cohort who were treated with BCG, no neoantigen-specific T cells were detected in urine during treatment. In the second cohort, 6 out of 6 TCRs from exhausted CD8(+) TILs from one patient recognized 5 different neoepitopes. T-cell receptor (TCR) repertoire analyses indicated that the frequencies of these tumor-specific T cells did not increase after BCG instillations, neither in the bladder nor in the blood. None of the 25 other TCRs of CD8(+) T cells recognized tumor-specific antigens. CONCLUSIONS: We show that one third of patients with non-metastatic bladder cancer mount a spontaneous and functional anti-neoepitope CD8(+) T-cell response detectable in blood or tumor. In 4 patients with NMIBC, BCG treatment did not boost or induce the anti-neoepitope response, suggesting alternative mechanisms of action for its efficacy.	bladder
Measuring what matters to patients: Systematic literature review of patient-reported outcomes assessment and reporting in locally advanced or metastatic urothelial cancer real-world and clinical studies.	INTRODUCTION: A systematic literature review (SLR) was conducted to evaluate patient-reported outcome (PRO) instruments used in clinical trials and real-world evidence (RWE) studies of locally advanced/metastatic urothelial cancer (la/mUC) therapies. METHODS: Five databases were used to identify publications up to May 29, 2024 and recent conference abstracts of phase 2/3 clinical trials and RWE studies. We reviewed reported adverse events and qualitative research to evaluate PRO instrument reporting quality using the CONSORT-PRO and ESMO-MCBS checklists. RESULTS: The SLR identified 37 trials and 12 RWE studies. High heterogeneity in PRO instrument choice was observed (11/18 different instruments were used in 1 study each). The most common instrument was the EORTC QLQ-C30 (36 studies). Minimal clinically important difference thresholds were not consistently used (9/36 studies reporting EORTC QLQ-C30 used a 10-point threshold). Based on qualitative research findings, assessed PRO instruments did not comprehensively capture patient concerns, with symptom coverage ranging from 27% to 82%. Unexpectedly, baseline EORTC QLQ-C30 and Short Form-36 scores indicated that patients with la/mUC have a similar quality of life to the general population. In 18/37 clinical trials, PRO timepoints preceded the median clinical follow-up, with differences ranging from 0.96 to 59.4 months. CONCLUSIONS: PROs can assist in the tailoring of treatment strategies to improve outcomes and can aid in enhancing communication between patients and healthcare professionals about treatment choice. Our evaluation of PRO reporting quality identified room for improvement in most studies, indicating a need for robust, consistent reporting of PRO data to adequately capture the experiences of patients with la/mUC.	bladder
[A Case of Bladder Squamous Cell Carcinoma Following LONG-Term-Indwelling Cystostomy].	A man in his 50s with an intellectual disability underwent a cystostomy for neurogenic bladder, followed by regular catheter exchange. Eighteen years later, the patient developed hematuria. Computed tomography and cystoscopy revealed a bladder tumor despite negative urinary cytology. Transurethral resection of the tumor confirmed the diagnosis of squamous cell carcinoma. Radical cystectomy was performed due to muscle invasion. Histopathological analysis revealed a pT3aN1M0 squamous cell carcinoma. No adjuvant therapy was administered, and the patient has remained recurrence-free for seven years postoperatively.	bladder
Impact of the preoperative modified 5-item frailty index on the efficacy of neoadjuvant chemotherapy in patients with muscle invasive bladder cancer.	PURPOSE: We aimed to determine the optimal treatment strategy for MIBC patients undergoing neoadjuvant chemotherapy (NAC) followed by radical cystectomy. We investigated whether preoperative frailty influences the efficacy of NAC by evaluating the Modified 5-item Frailty Index (mFI-5), which was developed as a comprehensive geriatric evaluation tool with a reduced number of variables to simplify data collection. METHODS: This retrospective study included 356 MIBC patients. Clinical information was collected retrospectively from medical records. Preoperative frailty was evaluated according to the mFI-5 score, and associations between NAC and clinical outcomes were investigated. Overall survival (OS) was evaluated by the Kaplan-Meier method and a Cox proportional hazard model. RESULTS: Patients who received NAC had significantly lower mFI-5 scores (P = 0.021) than those who did not. Although the preoperative mFI-5 score had a minor impact on other clinicopathological parameters, a significant difference in OS was found between patients mFI-5-low and mFI-5-high groups (P = 0.036). Furthermore, NAC significantly improved OS, especially in patients in the mFI-5-low group (P = 0.007), whereas no significant difference was found in patients in the mFI-5-high group. In patients who received NAC, the eGFR (HR=2.12, P = 0.024), pT stage (HR=2.29, P = 0.017), pN stage (HR=2.14, P = 0.044), and mFI-5 score (HR=2.23, P = 0.020) were independent predictors of OS. CONCLUSION: In patients who received NAC, the preoperative mFI-5 score and renal function were significantly associated with OS. Preoperative frailty, as evaluated by the mFI-5, might be an important factor for determining the indications for NAC in MIBC patients.	bladder
The effect of neoadjuvant chemotherapy on survival outcomes subsequent to radical cystectomy in pathological T0 bladder cancer patients: A multicenter large-scale analysis.	PURPOSE: After radical cystectomy (RC), the pathologic complete response (pT0) among muscle-invasive bladder cancer (MIBC) is considered a favorable oncological result. The objective of this study was to evaluate the effect of neoadjuvant chemotherapy (NAC) among the pT0 patients using a large-scale multicenter study. MATERIALS AND METHODS: This study included 3,972 patients who underwent RC at 11 tertiary medical centers. Analysis was conducted on patients with MIBC who achieved a pT0, with a focus on comparing results between those who received NAC and those who did not. Recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were analyzed in these groups. RESULTS: Among 252 eligible pT0 patients, 121 were categorized in the non-NAC group while the remaining 131 were in the NAC group. As compared to the non-NAC group, the NAC group demonstrated significantly better survival outcomes, with 5-year RFS rates of 89% vs. 80% (p=0.043), OS rates of 84% vs. 69% (p=0.011), and CSS rates of 95% vs. 80% (p=0.007). Multivariable Cox proportional hazards analyses demonstrated that NAC independently improved RFS (hazard ratio [HR] 0.192, p=0.002) and CSS (HR 0.200, p=0.020), but not OS (HR 0.672, p=0.263). CONCLUSIONS: In patients with MIBC who achieved a pT0, NAC administration prior to RC has a positive impact on oncological prognosis. Although further prospective studies are needed for validation, the results of this study will confirm the importance of NAC in MIBC.	bladder
Lactic acid regulates antitumor immunity in canine invasive urothelial carcinoma.	Canine invasive urothelial carcinoma (iUC) is a fatal malignant neoplasm that closely resembles human muscle-invasive bladder cancer in terms of histopathological features, molecular alterations, and clinical behavior. These similarities suggest that canine iUC represents a valuable spontaneous model for studying human bladder cancer. Tumor microenvironment (TME) plays a crucial role in tumor progression. Tumor-derived lactic acid has been implicated in the suppression of antitumor immunity and the promotion of tumor growth by altering the metabolic status of immune cells within the TME. However, the interaction between tumor metabolism and immune cells in the TME remains unclear in dogs. This study reanalyzed previously reported RNA-seq data to investigate the mechanisms underlying enhanced glycolysis in canine iUC. ERBB2 overexpression was found to induce AKT phosphorylation and increase extracellular lactic acid levels in vitro, activating the ERBB2-AKT-glycolysis axis and upregulating monocarboxylate transporter 4 (MCT4). MCT4 knockdown by RNA interference or pharmacological inhibition with diclofenac reduced lactic acid levels in the culture supernatant. Furthermore, MCT4 expression in canine iUC tissues was positively correlated with infiltrating regulatory T cell (Treg) counts. Functional studies revealed that lactic acid promoted Treg differentiation and suppressed IFN-γ production by effector T cells. These findings indicate that MCT4 mediates lactic acid efflux from glycolytic tumor cells, contributing to the suppression of antitumor immunity. Targeting tumor metabolism through MCT4 inhibition may represent a promising therapeutic strategy for canine iUC. Therefore, insights from the metabolic and immunological landscape of canine iUC may inform the development of translational therapies for both veterinary and human oncology.	bladder
Mixed-grade papillary urothelial carcinoma with a minor high-grade component shows a significantly worse clinical outcome than low-grade papillary urothelial carcinoma.	Grade heterogeneity is common in papillary urothelial carcinoma (PUC) of the urinary bladder. Mixed-grade PUC is generally treated as high-grade if the high-grade component accounts for ≥5 % of the tumor. However, the clinical behavior of predominantly low-grade PUC with a minor high-grade (<5 %) component remains uncertain. We retrospectively searched our pathology files and identified 52 cases of non-invasive mixed-grade PUC (predominantly low-grade PUC with a minor high-grade (<5 %) component). These patients' clinical outcomes were compared with those of 2 other cohorts, 52 cases of pure low-grade PUC and 50 high-grade PUC. During follow-up, 27 patients with mixed-grade PUC developed cancer recurrence in an average of 25 months, and 12 patients experienced progression to high-grade PUC, including invasive UC in 3 patients, in an average of 17 months. For comparison, 35 patients with low-grade PUC experienced cancer recurrence in an average of 17 months, but only 1 (2 %) experienced progression to high-grade non-invasive PUC; 34 patients with high-grade PUC experienced recurrence in an average of 13 months, and 10 (20 %) experienced progression to invasive UC. There was no significant difference in cancer recurrence in the 3 cohorts; cancer grade and stage progression rates in patients with mixed-grade PUC were significantly higher than those in those with low-grade PUC, but stage progression rate in patients with mixed-grade PUC was significantly lower than that in high-grade PUC. In conclusion, patients with mixed-grade PUC had a significantly worse clinical outcome than those with pure low-grade PUC but a significantly better outcome than those with high-grade PUC. Our results suggest that mixed-grade PUC should be treated as a distinct category from low-grade PUC.	bladder